The essential thing is to develop in oneself the thirst for learning and understanding
which may always prod us on. – Jawaharlal Nehru
A textbook on brain injury and management is picked by a neurosurgeon with some standard
expectations, namely, that it will touch the epidemiology of traumatic brain injury
(TBI), followed by chapters on pathophysiology, biomechanics, and then exhaustive
description of neurosurgical lesions that warrant surgery. Brain injury medicine is
a lot more, and makes a neurosurgeon introspect and realize that tackling only structural
lesions is not the only endgame. A lot remains yet to be unfolded. There is a huge
pool of knowledge waiting for translational channelizing into clinical practice. Admittedly,
there are significant voids in the translational methodology and applications.
TBI is a lifelong disease is a reality and requires continuum of care from prehospital
setting through acute care surgical procedures, onset of recovery, rehabilitation,
return to work and community reentry, and beyond. Each of these may be working in
silos and do not track recovery and other events in the continuum. TBI, especially
the severe grade, has extended natural history and lifelong effects, with protracted
recovery. Most often, it occurs early in life as compared with other devastating neurological
disorders. And it is most ironic that most of these injuries are preventable. A large
amount of text in the book is devoted to prevention of TBI and prehospital care.
There is extensive coverage of niche topics in TBI, namely, sports-related concussion,
and functional neuroimaging in TBI, posttraumatic pain issues, cognitive and neurobehavioral
disorders, and pediatric TBI including return to school. Neurological markers have
been reviewed with little to recommend in the overall management of TBI. A chapter
of life expectancy and wellness can assist the neurosurgeon to render an informed
advice and counsel the patient and the family and caregivers. A special section deals
with prevention of TBI, understandably the most vital aspect of TBI and the least
discussed. There are sections on sports injuries including chronic traumatic encephalopathy,
elder abuse, violence, and suicide. Assessment and treatment of posttraumatic fatigue
makes the clinician aware of this entity, so far relegated to all-encompassing postconcussion
syndrome. There are chapters on speech and swallowing disturbances following TBI,
activities of daily living, and return to leisure skills.
A complete section on neuropharmacology opens the scope of pharmacological agents
in neurorehabilitation, neuropsychiatry, and improvement of cognition. While critical
care and acute rehabilitation are dealt with in the usual manner, a chapter on neurosurgical
nursing and neurorehabilitation nursing covers an important aspect of paramedic training.
Principal merit of the book lies in appreciation of various aspects of brain response
to TBI, something that enables a neurosurgeon to take an evidence-based approach in
its overall management. For a practicing and academically inclined neurosurgeon or
neuroscientist, the book provides multiple targets for enhancing knowledge on TBI,
selecting a niche focus, and specialize in that focus. A section on ethics and medicolegal
aspects forms a fitting finale to the awesome compilation of knowledge on TBI.
The sheer size and weight of the book is daunting. In more than 1,300 pages of two-column
text, weighing approximately 10 pounds, that consolidates 19 sections and 91 chapters,
it integrates available knowledge, experimental or clinical, into translational resource
for the clinicians.
Besides the three principal editors, there is a vast team of contributors from practically
every field of medical sciences, underscoring the fact that brain injury is not the
exclusive domain of few. A psychologist and a rehabilitation nurse are important cogs
in the wheel.
Printer's devil: Page 360 mentions “Traumatic Intraparenchymal Gematomas.” I'm certain
the proofreaders and even the spell check missed that.
I am sure this book's addition to a departmental, institutional, or personal library
will be welcomed by neurosurgeons, neuroscientists, researchers, nursing, and rehabilitation
practitioners as a hugely valuable reference source.
Zasler ND, Katz DI, Zafonte RD, eds. Brain Injury Medicine: Principles and Practice. 3rd ed. New York, NY: Demos Medical (Springer); 2021. List price: US $314
